Meinicke Holger, Heinzmann Andrea, Geiger Julia, Berner Reinhard, Hufnagel Markus
Department of Pediatrics and Adolescent Medicine, University Medical Center Freiburg, Freiburg, Germany.
Pediatr Pulmonol. 2013 Dec;48(12):1246-9. doi: 10.1002/ppul.22704. Epub 2012 Nov 8.
While pleuropulmonary involvement in systemic lupus erythematosus (SLE) is a common occurrence, shrinking lung syndrome (SLS) is a rare complication of SLE, particularly in children. We report on a teenager girl with a primary SLE diagnosis, which was based upon clinical, imaging, lung-function and histological findings ascertained to be compatible with SLS. Following a pneumonia, the patient developed inflammatory residues in the lower lobes, an event that probably caused diaphragmatic immobility and subsequently led to SLS. Treatment response to steroids, cyclophosphamide and hydroxychloroquine in this case was excellent, and efficacy was more profound than previously has been reported in the literature with respect to pediatric patients. This case report argues that prognosis of SLS in SLE is likely to be favorable when the diagnosis is made early and the disease is treated appropriately.
虽然系统性红斑狼疮(SLE)累及胸膜肺部很常见,但肺萎缩综合征(SLS)是SLE的一种罕见并发症,在儿童中尤为如此。我们报告一名初诊为SLE的青少年女性,其诊断基于临床、影像学、肺功能和组织学检查结果,确定与SLS相符。肺炎后,患者下叶出现炎症残留,这一情况可能导致膈肌运动障碍,进而引发SLS。该病例对类固醇、环磷酰胺和羟氯喹的治疗反应良好,疗效比以往文献报道的儿科患者更为显著。本病例报告表明,SLE合并SLS若能早期诊断并得到恰当治疗,预后可能良好。